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• W1784577273 abstract "To characterize a cohort of children with non-neurogenic daytime urinary incontinence followed-up in a tertiary center. Retrospective analysis of 50 medical records of children who had attained bladder control or minimum age of 5 years, using a structured protocol that included lower urinary tract dysfunction symptoms, comorbidities, associated manifestations, physical examination, voiding diary, complementary tests, therapeutic options, and clinical outcome, in accordance with the 2006 and 2014 International Children's Continence Society standardizations. Female patients represented 86.0% of this sample. Mean age was 7.9 years and mean follow-up was 4.7 years. Urgency (56.0%), urgency incontinence (56.0%), urinary retention (8.0%), nocturnal enuresis (70.0%), urinary tract infections (62.0%), constipation (62.0%), and fecal incontinence (16.0%) were the most prevalent symptoms and comorbidities. Ultrasound examinations showed alterations in 53.0% of the cases; the urodynamic study showed alterations in 94.7%. At the last follow-up, 32.0% of patients persisted with urinary incontinence. When assessing the diagnostic methods, 85% concordance was observed between the predictive diagnosis of overactive bladder attained through medical history plus non-invasive exams and the diagnosis of detrusor overactivity achieved through the invasive urodynamic study. This subgroup of patients with clinical characteristics of an overactive bladder, with no history of urinary tract infection, and normal urinary tract ultrasound and uroflowmetry, could start treatment without invasive studies even at a tertiary center. Approximately one-third of the patients treated at the tertiary level remained refractory to treatment. Caracterizar uma coorte de crianças com incontinência urinária diurna não neurogênica acompanhada em serviço terciário. Análise retrospectiva de 50 prontuários de crianças com controle miccional ou idade mínima de cinco anos, por meio de protocolo estruturado, que incluiu sintomas de disfunção do trato urinário inferior, comorbidades, manifestações associadas, exame clínico, diário miccional, exames subsidiários, opções terapêuticas e evolução clínica, conforme normatizações da International Children's Continence Society, de 2006 e 2014. Eram do sexo feminino 86% dos pacientes. A idade média foi de 7,9 anos e o seguimento médio de 4,7 anos. Urgência (56,0%), urge-incontinência (56,0%), retenção urinária (8,0%), enurese noturna (70,0%), infecção do trato urinário (62,0%), constipação (62,0%) e perda fecal (16,0%) foram os principais sintomas e comorbidades. Exames de ultrassom apresentaram alterações em 53,0% dos casos, e o estudo urodinâmico, em 94,7%. Na última consulta, 32,0% dos pacientes ainda apresentavam incontinência urinária. Ao analisar os métodos diagnósticos, observou-se concordância de 85,0% entre o diagnóstico preditivo de bexiga hiperativa obtido pela história clínica mais exames não invasivos e o diagnóstico de hiperatividade detrusora obtido pelo estudo urodinâmico O subgrupo de pacientes com quadro clínico característico de bexiga hiperativa, sem antecedentes de infecção urinária, ultrassom de vias urinárias e urofluxometria normal poderia iniciar tratamento sem a necessidade de estudos invasivos, inclusive em serviço terciário. Aproximadamente um terço dos pacientes com incontinência urinária atendidos em serviços terciários permanecem refratários ao tratamento." @default.
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• W1784577273 date "2016-03-01" @default.
• W1784577273 modified "2023-10-14" @default.
• W1784577273 title "Clinical course of a cohort of children with non-neurogenic daytime urinary incontinence symptoms followed at a tertiary center" @default.
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• W1784577273 doi "https://doi.org/10.1016/j.jped.2015.04.005" @default.
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